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HIV Retinopathy — SCE Infectious Diseases MCQ

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HardHIV MedicineHIV RetinopathySCE Infectious Diseases

A newly diagnosed patient with HIV has a CD4 count of 38 cells/mm3 and no visual symptoms. Which ophthalmic assessment is specifically recommended because of his immunological status?

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Correct answer: D — Fundoscopy or retinal photography to look for CMV retinitis

BHIVA recommends fundoscopy or retinal photography for CMV retinitis in people with CD4 counts below 50 cells/mm3 because disease may be asymptomatic initially and occurs predominantly with profound immunosuppression. A normal visual history does not remove the indication. The alternatives do not target the relevant opportunistic retinal disease.

Reference: BHIVA guidelines for routine investigation and monitoring of adults living with HIV-1: https://www.bhiva.org/wp-content/uploads/2024/10/Monitoring-Guidelines.pdf